Two of the nation's leading experts on healthcare quality—Dr. Bob Wachter, professor and chief of the division of hospital medicine at UCSF Medical Center in San Francisco, and Dr. Mark McClellan, senior fellow and director of the Health Care Innovation and Value Initiative at the Brookings Institution and former administrator of the CMS—called for new ways of measuring clinical quality and outcomes during Modern Healthcare's second annual Virtual Conference on Quality and Patient Safety on June 18. The following are edited excerpts from a plenary panel moderated by editorial programs manager Maureen McKinney.
Dr. Bob Wachter on “feeding the measurement beast”: I had the privilege to spend the day at Boeing and fly a 777 simulator. One of the things I learned is the degree to which they try to protect the pilots from too many measurement requirements, because they know they can get in the way of them focusing on their work. Bob Myers, Boeing's chief flight deck engineer, a very interesting guy, said to me, “Airlines are always asking the pilots, 'Can you just document what time you took off, how much gas you had when you started, and then, did you have any passenger complaints?' So the pilots spend a fair amount of time on a computer or their iPad documenting things. But they don't do that stuff below 10,000 feet.”
So I said, “Well, we're constantly doing that stuff below 10,000 feet in terms of documentation in healthcare,” and Bob said, “That's the difference. When you're in the OR or with the patient, you're below 10,000 feet, and you shouldn't be doing that stuff.”
So the degree to which quality measurement has created an extraordinary burden for clinicians who have to enter all of that stuff in our records while we're trying to take care of patients, I think it's been vastly underestimated by the promulgators of quality measurements. It's a very, very important issue.